The Impact of Lifestyle Interventions and Mental Health Management on Arrhythmias in Heart Failure

Purpose of Review To summarise contemporary evidence on the impact of lifestyle interventions and mental health management on arrhythmias in patients with heart failure (HF), and to highlight emerging therapeutic opportunities. Recent Findings Lifestyle modification targets shared risk factors in both arrhythmias and HF. In atrial fibrillation (AF), weight loss, exercise, alcohol reduction, and risk factor management reduce arrhythmia burden and improve arrhythmia-related symptoms and quality of life. Similarly, in both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), exercise training improves functional capacity and quality of life, whilst dietary interventions and weight loss are particularly beneficial in HFpEF. Mental health disorders represent novel targets for intervention for arrhythmias in HF; these conditions are common in arrhythmia and HF patients and associated with poorer outcomes, but early data suggests that mental health interventions do not reduce arrhythmia burden or cardiovascular outcomes despite improving overall psychological well-being and quality of life. Summary Lifestyle intervention to improve physical health is central to HF and arrhythmia care and established as a central pillar of management. Mental health represents an important but under-recognised target which requires urgent further investigation.